Annals of Surgical Oncology

, Volume 26, Issue 13, pp 4673–4680 | Cite as

The Prognosis and Natural History of In-Transit Melanoma Metastases at a High-Volume Centre

  • Emilia Nan Tie
  • Lumine H. Na
  • Rodney J. Hicks
  • John Spillane
  • David Speakman
  • Michael A. Henderson
  • David E. GyorkiEmail author



Patients with in-transit melanoma metastases (ITM) experience a diverse spectrum of clinical presentations and a highly variable disease course. There is no standardized treatment protocol for these patients due to the limited data comparing treatment modalities for ITM. This is the first study to describe the disease trajectory and natural history of a large cohort of patients with ITM.


A retrospective study of patients treated for ITM between 2004 and 2018 at the Peter MacCallum Cancer Centre was performed. Clinical and pathological characteristics for primary and in-transit episodes were analyzed for predictors of relapse-free survival (RFS), distant metastasis-free survival (DMFS), and melanoma-specific survival.


A total of 109 patients with 303 episodes of ITM were identified: 52 (48%) females, median age 70.1 years (range 35–92). The median RFS for all episodes was 5 months (95% confidence interval [CI] 4.2–5.7). Eighty-seven percent of episodes involving isolated in-transit lesions underwent surgical excision, compared with 17% involving more than five in-transit lesions. A trend was seen between a greater number of lesions and shorter RFS (p = 0.055). The median DMFS was 34.8 months (95% CI 22.8–51.6). Factors associated with shorter DMFS included primary tumor thickness (hazard ratio [HR] 1.08, 95% CI 1.01–1.15; p = 0.026), site of primary tumor (p = 0.008), and BRAF mutation (HR 2.12, 95% CI 1.14–3.94; p = 0.018).


Locoregional relapse is common in patients with ITM regardless of treatment modality. Characteristics of the ITM may predict for RFS, while primary tumor characteristics remain important predictors of DMFS.



Melanoma Research Victoria.


No sources of funding were used in the preparation of this study.


Emilia Nan Tie, Lumine H. Na, Rodney J. Hicks, John Spillane, David Speakman, Michael A. Henderson, and David E. Gyorki have no conflicts of interest to declare.

Supplementary material

10434_2019_7965_MOESM1_ESM.docx (12 kb)
Supplementary material 1 (DOCX 12 kb)


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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Emilia Nan Tie
    • 1
    • 2
  • Lumine H. Na
    • 3
  • Rodney J. Hicks
    • 4
    • 5
  • John Spillane
    • 1
    • 2
  • David Speakman
    • 1
  • Michael A. Henderson
    • 1
    • 2
  • David E. Gyorki
    • 1
    • 2
    • 6
    Email author
  1. 1.Division of Cancer Surgery, Department of Surgical OncologyPeter MacCallum Cancer CentreMelbourneAustralia
  2. 2.Department of SurgeryThe University of MelbourneMelbourneAustralia
  3. 3.Centre for Biostatistics and Clinical TrialsPeter MacCallum Cancer CentreMelbourneAustralia
  4. 4.Centre for Cancer ImagingPeter MacCallum Cancer CentreMelbourneAustralia
  5. 5.Department of Medicine/Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneAustralia
  6. 6.Victorian Comprehensive Cancer CentreMelbourneAustralia

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